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处方运动疗法(PAP):初级医疗保健中一项随机对照试验的成本与结果

Physical activity on prescription (PAP): costs and consequences of a randomized, controlled trial in primary healthcare.

作者信息

Romé Asa, Persson Ulf, Ekdahl Charlotte, Gard Gunvor

出版信息

Scand J Prim Health Care. 2009;27(4):216-22. doi: 10.3109/02813430903438734.

Abstract

OBJECTIVES

To analyse costs and consequences of changing physical activity behaviour due to the "Physical Activity on Prescription" (PAP) programme.

DESIGN

A randomized controlled trial with a four-month intervention, with comparison between intervention and control group. Intervention. The PAP programme, with exercise twice a week, education, and motivational counselling.

SUBJECTS

525 sedentary individuals, 20-80 years (intervention group n = 268, control group n = 257), with lifestyle-related health problems. A total of 245 returned for the four-month assessment.

MAIN OUTCOME MEASURE

Programme costs based on intention-to-treat estimations, direct and indirect costs of inactivity, and physical activity behaviour analysed with IPAQ (International Physical Activity Questionnaire), self-reported physical activity, and measures of functional capacity.

RESULTS

The intention-to-treat programme costs for the four-month programme period was SEK (Swedish Kronor) 6475 (euro [Euro] 684) for the intervention group and SEK 3038 (euro 321) for the control group. Of this, healthcare providers' costs were 24% in the intervention group, and 31% in the control group. The physical activity behaviour was significantly improved in both groups, but no differences were found between the groups. Implications. The largest share of the PAP programme costs was the participants' costs. Significant improvements were shown in physical activity behaviour in both groups, but no differences were found between the intervention and control groups. Due to many non-completers, the potential for improvements of the motivating assignment with sedentary individuals in primary healthcare is obvious. Long-term follow-up can determine the sustainability of the results, and can be used in a future cost-effectiveness analysis.

摘要

目的

分析因“运动处方”(PAP)计划而改变身体活动行为的成本和后果。

设计

一项为期四个月干预的随机对照试验,比较干预组和对照组。干预措施为PAP计划,包括每周两次运动、教育和动机咨询。

研究对象

525名久坐不动的个体,年龄在20至80岁之间(干预组n = 268,对照组n = 257),患有与生活方式相关的健康问题。共有245人返回进行四个月的评估。

主要结局指标

基于意向性分析估计的计划成本、久坐不动的直接和间接成本,以及使用国际体力活动问卷(IPAQ)、自我报告的身体活动和功能能力测量方法分析的身体活动行为。

结果

在四个月的计划期内,干预组的意向性分析计划成本为6475瑞典克朗(684欧元),对照组为3038瑞典克朗(321欧元)。其中,干预组医疗保健提供者的成本占24%,对照组占31%。两组的身体活动行为均有显著改善,但两组之间未发现差异。启示:PAP计划成本的最大部分是参与者的成本。两组的身体活动行为均有显著改善,但干预组和对照组之间未发现差异。由于许多人未完成干预,在初级医疗保健中对久坐不动个体的激励性干预措施的改进潜力明显。长期随访可以确定结果的可持续性,并可用于未来的成本效益分析。

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